Managing Diabetes in School Settings

The important focus of today's episode revolves around the management of blood sugar levels in students, a matter of considerable significance. We delve into the nuances of recognizing the signs of blood sugar irregularities and explain effective strategies for students managing diabetes during the school day. Our esteemed guest, Jennifer Hanlon, the consulting school nurse for Area 5, offers invaluable insights into the critical symptoms that parents and educators should be vigilant about, as well as the interventions that can be instituted to support affected students. Moreover, we explore the broader implications of diabetes on a child's cognitive and emotional well-being, particularly during the tumultuous middle school years. This dialogue aims to give parents and educators the necessary knowledge and resources to foster an environment conducive to the well-being of students grappling with diabetes, thereby ensuring their academic success and emotional stability.

Guest:

Jennifer Hanlan

Useful links from the podcast:

• Pediatric Healthcare | Children's Healthcare of Atlanta
• School Health Services

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Takeaways:

• The management of blood sugar levels in students is crucial for their cognitive function and overall academic performance, necessitating vigilance from both parents and school staff.
• Parents should be aware of red flags indicating potential blood sugar issues in their children, such as excessive thirst and frequent urination, which warrant further consultation with medical professionals.
• School nurses act as important advocates for students with diabetes, ensuring they receive appropriate accommodations and support in the academic environment through individualized healthcare plans.
• Understanding the psychological and social implications of diabetes among peers in a school setting is vital for fostering a supportive environment for affected students, particularly during the challenging middle school years.

Episode Transcript

(00:00):
Whether you pronounce itdiabetes or diabetes, we're talking
about managing sugar levels inschool today on the Inside Scoop.
Hello, I'm David Owen. Beforewe dive in, don't forget to, like,
subscribe and share thisepisode with anyone who wants to
stay informed about what'shappening in our schools. Your doing

(00:22):
this helps us reach morefamilies who care about student wellness.
Today, we're tackling a topicthat affects many students but often
goes unnoticed. Recognizingthe signs of blood sugar issues and
understanding how diabetes canbe safely managed during the school
day. Here to help us know whatto look for and how to deal with

(00:43):
it in a school setting is ourconsulting school nurse for Area
5, Jennifer Hanlan. Jennifer,welcome to the podcast.
Hi. Thank you for having me.
Everybody knows Area 5, right?
Yeah.
Maybe kind of cryptic. Whatschool are in Area 5? Just a few
of them.
Okay, so I'll name the highschools because I've also served
those feeding schools. SoMcEachern, Hillgrove, Harrison and

(01:08):
Allatoona high schools, andthen all of those feeders. So 22
schools in Area 5.
So diabetes, you pronounce it diabetes?
I pronounce it diabetes.
Just making sure I'm not theoutlier here. So how. How might untreated
high or low blood sugar levelsaffect a student's ability to learn

(01:30):
throughout the school day?
Good question. So the bloodsugar levels in children who have
diabetes is pretty importantfor their cognitive function. So
whether it be low, like, youknow, maybe under 60, you know, it
starts to impair theircognitive learning ability. They

(01:52):
might get confused,lightheaded, shivery shakes, sweaty.
You know, they're just able tocomprehend, make complete thoughts
and things like that. So itmakes a big difference. And if it's
super high, they also havecognitive, you know, effects. So

(02:13):
being able to learn,comprehend, test things like that
are big. That's where thenurses come in and advocate for those
children.
Okay, so when we're talkingabout, essentially for the sake of
this podcast, talking aboutblood sugar levels that are outside
of the normal range. Right. Soif I'm a parent and I am concerned

(02:38):
maybe about my child zoningout during class, what are some of
the things that in the day today I can look for as a red flag
of not necessarily adefinitive thing, but a concern that
I need to maybe talk to theschool nurse about?
Sure. So there are several bigred flags that would, if they were

(03:01):
brought to us in the clinic,it would spark us to say, okay, we
might need a trip to thepediatrician. Those things would
be excessive thirst. We'retalking pounding water day in, day
out, you know, extreme, youknow, needing to use the restroom,
going to the restroom a lot.And a lot of times kids are in school

(03:24):
seven hours a day, you know,so those teachers are huge in being
able to help report thatlittle Johnny is going to the restroom
every 15 minutes. He hasrefilled his bottle 16 times today.
You know, those are big redflags in the elementary age kids
for parents. If your kid is in4th or 5th grade and has been, you

(03:47):
know, not wet the bed sincekindergarten and he starts wetting
the bed, those are kind of redflags for parents and things to people
to take notice of and bringthose to the attention of a medical
professional, whether it bethe school nurse or your pediatrician.
And to that point, you know,we talking about teens in particular.

(04:10):
They are sneaky. I've got afew. Yes. So when they are needing
to go to the restroom, that'slegitimate. That's your red flag
when they're needing to go tothe restroom because, well, they
don't want to take the test.That's not correct. Okay.
Correct.
Just making sure that's clear.Yes. So is there a particular age?

(04:31):
I mean, just a moment ago youtalked about elementary school versus
high school, middle school. Isthere an age where is most frequently
picked up on that? There is an issue?
There is not. So anyone candevelop diabetes at any point during
their lives. Typically itoccurs in the adolescent's age, but

(04:53):
it's not just, you know,limited to that age. Like I was just
a little more science behindit is an autoimmune disease. So an
autoimmune disease. Anautoimmune disease.
I'm sorry to interrupt you,but that's kind of surprising.
It is. So what happens is anykind of infection, viral, things

(05:15):
like that, your body naturallywill go to fight it. And once you
have overcome that virus andyour body doesn't stop fighting it,
it can start attacking othercells, which is the autoimmune issue.
So in this case, your pancreasis attacked and it stops producing
insulin, which.

(05:36):
Is very, very bad, I would think.
Yes. That is the hormone thatcarries or helps convert the glucose
into energy.
Okay, so at that point, itwould be, I mean, going back to the
red flags if a kid startspassing out, that's huge.
That's super bad. Yes.
Yeah. Okay, so you've missed afew flags along the way. It sounds
like.
Right.

(05:57):
So low blood sugar. I rememberback in the 1900s when I was in school.
1900S.
It sounds farther and fartheraway. It does. Every single Day.
So I remember one student, andI believe it was a middle school
setting, his blood sugar wouldplummet and he would start acting,

(06:22):
frankly, crazy. I mean, doingthings that no logical, thinking
human would do. Is that.
Yes.
That's another red flag.
That is a lot of kids, if theycan become super hyperactive or very
irritable, likeuncharacteristically irritable and

(06:42):
snippy. Yes. And they justhave no control over that. Their
brain doesn't have thatglucose to function the way it's
supposed to. Absolutely. And alot of teachers maybe not understand
that, and they just thinkthey're a problem child, but actually
they need to come see thenurse. Let's figure out the problem

(07:05):
and, you know, treat them andallow them to go back to school.
What are some of the thingsthat parents should do to help advocate
for their student in thesetting of a school?
Absolutely. So parents, Ialways present this in 504 meetings
for my students who havediabetes. They are that child's advocate.

(07:26):
They are the voice of thatchild. And so I really and truly
want to make sure that theyknow what's available to them, what
kind of supports are availableto them and.
Excuse me for interrupting,but you said 504 meetings. That's
a plan to address an unusualcircumstance, medical needs.

(07:46):
So a 504 is kind of.
What.
They like to say is it levelsthe playing field for a child with
a chronic illness or any kindof medical condition which could
affect them academically. Theyhave things in place that allow them
to, like, check blood sugarsbefore testing to make sure they're

(08:09):
in an acceptable range to sitfor a test.
Yeah. And the student would dothat themselves.
Correct. I mean, technology isamazing. They've got the CGMs, the
constant continuous glucosemonitors that they wear on the back
of their arms. I'm sure you'veseen those. And then it transmits
to their phone or somethinglike that. So technology is amazing.

(08:30):
Yeah, it is. And it takes alot of the load off of everybody
around them.
Correct.
So they can learn to manage itthrough their lifetime.
Of course, yes. And that is.It is a lifelong illness that they
are going to have to managethroughout their entire life. You
know, whether or not they arediagnosed at 18 months or they are
diagnosed at 24, it doesn'tmatter, you know, it's still going

(08:52):
to be a lifelong situation.
Okay, so I pulled you offtrack slightly.
Sorry.
No, that's fine. That's myfault. The 504 meeting basically
helps keep everybody on thesame page of what's going on and
what else you were talkingabout in those meetings? Talking
about parents advocating for their.
Yes. And a lot of times, youknow, when a child is newly diagnosed

(09:13):
with diabetes, it is lifechanging for the parent as well.
There's a lot of informationthat they need to learn and understand
about diabetes to help supporttheir child. So, you know, children's
healthcare of Atlanta isamazing and they have caregiver classes
that they give. But you know,on the school side of things, they

(09:33):
don't get that information ofhow we can support them at school
using a 504 or an individualhealthcare plan, things like that.
Okay. All right. So I'm justtrying to think through the day to
day picture for a student whois managing their own blood sugar

(09:54):
levels. What are some of theexceptions that might come out of
a 504 plan? I think you kindof mentioned it a little bit, but
teachers have to deal with afull classroom of students and some
of them are again, in theteenage mind trying to get away with
stuff. What are some of thethings that are frequently allowed,

(10:18):
not always perhaps, butfrequently allowed for a student
to do that otherwise might bean exception.
Okay, so, you know, they have.So their cell phone, like I mentioned
earlier, is connected to theircontinuous glucose monitor. And so
that cell phone is considereda medical device. Okay. So that device

(10:41):
has to stay within 20ft ofthat student at all times. So a lot
of times we write into theplan saying that their cell phone
is a medical device and theyhave access to it at any time. Okay.
Something else is they cancheck their blood sugars whenever
they need. They can have waterand food accessible to them at all

(11:01):
times because that's also howyou help treat lows and keep things
in check. Drinking water willhelp lower blood glucose as well.
So we kind of include a lot ofthose. Another big thing that maybe
not a lot of people understandis on field trips. Field trips is

(11:22):
a huge issue with a diabeticbecause once you, if you are super,
super high and unmanaged, youcan go into ketoacidosis. I'm not
going to get into the. Butthat's dangerous. And also if you
go super low, you can go intoa diabetic coma. So and in those
situations, there has to be amedical professional available to

(11:44):
that student to help managebecause there's emergency meds. There
are things that we can do tohelp support that child if they get
into a crisis situation.
See, this is one of thosethings that's behind the scenes that
makes me love cub schools andCompany man. Okay, guilty. But the
fact that as parents, we don'teven have to think about having somebody

(12:05):
who is equipped and ready todeal with this sort of unknown thing.
Otherwise, hopefully, kidsdon't want to have the stigma of,
oh, he's diabetic. They don'twant to be talking about that among
their peers. So keeping thaton the down low, as they say, but
being prepared is huge, right?
It is.

(12:26):
So earlier you mentioned someof the physiological impacts of unmanaged
blood sugar levels. What aboutthe, I guess, the social impacts
or psychological impacts ofhaving a situation that's not normal
among peers? Is that somethingthat is of concern in the school

(12:49):
environment?
Absolutely, absolutely. And Iwill say, you know, you see more
of that impact, the social,emotional, mental aspect of it, come
maybe in middle school where,you know, everybody knows middle
school is not, you know.
Middle school is lovely.
Really? Yeah, yeah. I mean,it's such an awkward time for everyone,

(13:10):
but that, you know, thechildren really don't want to be
different from their friends.They don't want to have to stop doing
what they're doing to managetheir blood sugar and things like
that. So it does take a hugerole or toll on them, you know, emotionally,
you know, and, you know, we'veseen, you know, students really go

(13:32):
through a lot in that sense,and, you know, having the nurse in
the school who understand it,then we take it to another level.
So we let the teachersunderstand what's happening with
this child, how to treat them,or just giving them a basic understanding
so that they can relate tothat student and maybe not bring

(13:53):
it out in front of otherpeople, but just having that understanding
that they are going throughsomething and be supportive, you
know?
Yeah, absolutely. And you hitthe nail on the head. Kids do not
want to be noticed or calledout for something unusual like that.
Absolutely.
I could imagine a middleschooler in particular not taking

(14:15):
care of themselvesappropriately because they don't
want to stand up and go dosomething for fear of being noticed.
Right?
You are absolutely correct.And that's a lot of what we see in
the middle school. That'sprobably the hardest age to manage
diabetes for a child.
So in preparing for thispodcast, I noticed that you guys

(14:37):
have a great resource on theschool nurses website or webpage
on the Cobb Schools websitethat might be of benefit to our viewers,
our parents. Very briefly, canyou give us a description of what
they can find there?
Absolutely. So on that site,you're going to have resources as,

(15:03):
you know, kind of our policiesand how we manage diabetes in the
school setting as well as theforms, the medical forms that we
need filled out by doctors.Also, Children's Health Care of Atlanta,
I mentioned earlier is afantastic resource for parents to

(15:23):
be able to contact. And theyare. They are a wealth of information,
to be honest. And you canalways contact your local school
nurse. They are more thanwelcome to answer any questions.
You know, maybe ease yourconcern or your worries about sending
your newly diagnosed child toschool with diabetes, because that
is a huge concern for parents.

(15:45):
Sure. And our school nursesare well prepared. So don't fret.
Well, Jen, thank you so muchfor coming in and sharing on this
very important information.Parents need as much info as they
can possibly get, and thatpage of resources we will make sure
is available through a link onthe podcast description or in the

(16:08):
show notes. You'll find it oneplace or the other. If you found
this conversation helpful, besure to like, subscribe and share.
It really helps us reach moreof those families and keep everyone
connected to what's happeningin the schools and especially on
topics of this level ofimportance. Could possibly even save
a life. Not to put pressure onyou, but do it. And don't forget,

(16:33):
we're also available on iHeartpodcast, Spotify, Apple, and anywhere
you get your podcasts. Sothank you for listening to this edition
of the Inside Scoop, a podcastproduced by the Cobb County School.